When it comes to the debate between complete abstinence or alcohol moderation, advice can dramatically differ, leaving many people confused and unsure which path to take to make a positive change in their lives. While many view abstinence as the only option for a healthy future, this “one size fits all” approach has been challenged, as it doesn’t necessarily take into consideration people who have the motivation and confidence to improve their relationship with alcohol or for those who feel such a drastic step as quitting alcohol forever is not required.
There are many paths to wellness, and it is for the individual to choose the right goal for them. The likelihood of successful moderation does depend on the severity of the alcohol use disorder, with evidence suggesting that those who have a mild to moderate use disorder have the best chances of cutting down. Most people in the population who have alcohol issues fall into this category and with structured support can bring their drinking down to safer levels.
What is alcohol abstinence?
Alcohol abstinence is the decision to cut booze out of your life completely and permanently. Depending on the severity of the presenting issue, this is often seen as the safest way to move forward, and for many, it eliminates any risk or uncertainty that may come with finding the right path to moderation. When considering or committing to complete abstinence, the AA is the most commonly known program of support, offering more than 123,000 meetings worldwide, working through the infamous “12-step programme”, created in 1935. This program is the predominant recovery method in treatment centres all around the world (interestingly around 90% of centres in the US).
Another organisation who advocates abstinence is Smart Recovery , Their belief is that commitment is the “number one factor for sobriety success” and from that commitment comes a “feeling of freedom” where “your life can be restored to where you are in control” and “your addiction and the urges will recede to an unpleasant memory”.
Abstinence is certainly the advisable route for those with a severe alcohol use disorder (AUD), although many with mild or moderate symptoms may also opt for an alcohol-free life if they feel that it just isn’t working for them anymore. For example, the drawbacks are outweighing the benefits, or they are noticing a negative effect on their health.
What is alcohol moderation?
Alcohol moderation or “harm reduction” is increasingly considered a viable pathway for those suffering with an alcohol use disorder (usually at a mild or moderate level) but don’t wish to cut out booze completely from their lives. This means that they may be looking for a way to review and modify the amount and frequency of their intake. If you are interested in some tips on how to cut down you drinking you can find it here.
Moderation has been defined as low-risk drinking and according to Drink Aware the current recommendation is 14 units for both men and women spread across three or more days. This is approximately a bottle and a half of wine or 14 single measures of a spirit.
Moderation Management is a well-known behavioural change program in the harm reduction field. It defines a moderate drinker as a person with the following characteristics.
Historically, treatment options for moderation have been extremely limited and it’s only in recent years that we have seen an increase in alternative solutions for those who have a mild to moderate alcohol issue. TV presenter and alcohol moderation advocate Adrian Chiles, in his 2022 book The Good Drinker shares his journey from over drinking to wellness. Chiles points out the “tragedy” is that many people are frightened to seek support for their drinking because they believe they’ll be told that abstinence in their only option. As a result, “they just continue drinking as they were”. He argues that because of this, “their consumption of alcohol won’t be addressed, and they’ll sink deeper into problem drinking territory and a level of dependence that means, abstinence, in the end, really could be the only answer”.
What alcohol moderation book might be right for you? I have reviewed many other books to help you cut down on alcohol here if you are interested to see my favourite.
Conventional wisdom may have you believe that if you suffer with alcohol issues on any level then abstinence-based recovery is the only option since it is an incurable disease that will get worse over time. However, as you will discover, the evidence reveals a different picture. The eminent researchers, Linda and Mark Sobell of the Addiction Research Foundation of Toronto, Canada in 1995, after nearly three decades of study into alcohol use, concluded in a research paper in 1995 that if you are someone who does not have a serious physical dependence you can implement moderation techniques and be successful in the long term.
A national five-year study in the US of 43,000 people sponsored by the Institute of Alcohol Abuse and Alcoholism, concluding in 2005, highlighted evidence that the majority of people can change their drinking habits through education in a non-confrontational manner relating to impact and risks of over drinking. Interestingly, they also found that over a lifetime 30 per cent of adults will experience an Alcohol Use Disorder, yet 70 per cent of those people will transition to safe drinking patterns over time.
The World Health Organisation (WHO) undertook research in 1996 with 1,490 heavy but non-dependent drinkers at ten differing locations across the world who had each received a short intervention relating to alcohol. The group was monitored nine months after receiving the support and information and it was discovered that the group had managed to curtail their consumption by one third.
How would I decide what’s right for me?
It’s considered that those without a physical dependence on alcohol, such as mild to moderate use disorder are more likely able to reduce their intake to safer levels and move forward to live happier lives. If moderation is your chosen objective, then I would suggest you try it and see how you get on, you wont know if it’s possible until you commit to a structured approach, track your journey towards moderate drinking and review your progress.
If you are curious to get a better understanding of where you might fall on the continuum of alcohol use disorder then the guidelines set by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) may be helpful. You will be able to establish the difference between alcohol abuse and physical dependence. It also helps to establish whether Alcohol Use Disorder (AUD) is present and within that, the severity of the condition (mild, moderate or severe) through an analysis of symptoms over a 12-month period.
What would a good Moderation Program involve?
The key premise of any approach is that moderate drinking is a practical and reasonable goal for those people who face less severe drinking issues. There are a great many differences in peoples’ over drinking behaviours and it is important for the therapist to assess and help the client manage their individual triggers for overdrinking. In addition, it is advantageous to identify the client’s personal motivation for change. Ideally the client will develop a toolkit of strategies to facilitate the behaviour changes.
A good programme may include the following,
How can I help you in your alcohol moderation journey?
Clinical hypnotherapy and moderation techniques can be highly effective in reducing your alcohol intake and I am here to help. Many of my clients see a dramatic improvement in relation to drinking in a short space of time. Please feel free to get in touch with me to book a FREE phone or Zoom consultation using the link below.